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A patient's guide to cosmetic surgery sponsored by Nuffield Health

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Nuffield Health, a leading provider of cosmetic surgery in the UK, with a network of 30 private hospitals across the country.

Cosmetic surgery

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Eyelid surgery guide

Eyelid surgery

Eyelid surgery is a cosmetic surgery technique used to remove fat and excess skin around the eyes that make the eyes look tired and old. It is known medically as blepharoplasty and can be done on the upper or lower eyelids, or both together.

Why consider eyelid surgery?

As we get older, our skin becomes more elastic and our muscles become less toned. When this occurs around the eyes, it can lead to excess skin that forms bags below the eyes and wrinkles or hoods on the upper eyelids, making you look weary and worn out and adding years to your appearance.

Eye surgery is a simple procedure that removes this excess skin and fat and renews the smoothness and tone of the remaining skin and muscle. It can eliminate eye bags, wrinkles, crow’s feet and upper eyelid hoods, resulting in a fresher, more rested, more youthful look. Since the removed fat does not return, this refreshed look will last for a number of years until increased skin elasticity through aging becomes a problem again.

What does eyelid surgery involve?

The type of eyelid surgery you have will affect the nature of the operation. Most upper eyelid surgery is done under local anaesthetic with sedation, while lower eyelid surgery, or combined eyelid surgery is usually done under a general anaesthetic. In most cases, eyelid surgery is done as day case, although you may need to stay overnight if you have had a general anaesthetic.

For upper eyelid surgery, the incision is made in the natural crease of the eyelid. This is to hide any resulting scars. The surgeon will remove any excess skin and fatty tissue, and pull the remaining skin tighter, so that it has a naturally smooth, wrinkle free appearance. The incision is then stitched and held in place using sterile strips of tape. Your surgeon may ask you to open and close your eyes during the procedure to see how smooth the skin is.

For lower eyelid surgery, or eye bag removal, the incision is made just below the eyelashes to minimise the visibility of the scars. Again, any excess skin, fatty tissue or muscle is removed and the remaining skin smoothed before the wound is stitched. If your surgeon is only removing fatty tissue, with no excess skin removal, they may make the incision just behind the eyelashes, within the eye socket itself.

After your eyelid surgery

You will not fully enjoy the results of your eyelid surgery for several weeks, until the swelling has gone down and any bruising has disappeared. Your stitches will normally be taken out after a few days, but you may still need the surgical tape strips to maintain the integrity of the wound.

During the first few days, you are advised to keep your head upright to reduce pressure around the wounds. You will also need to clean the wounds with water and apply any ointment or eye drops you were given when you were discharged. You will not be able to wear eye makeup until your surgeon gives you the all clear.

You may experience swelling and bruising for the first couple of weeks. This is perfectly normal and should subside with time. You may experience dry eyes or your eyes may water excessively, and many patients will experience both conditions during their recovery. Your eyes may also be more sensitive for a few days. Some patients experience blurred vision in the first few days, due to the trauma of surgery so close to the eye, but this will quickly pass. If it persists, you should consult your cosmetic surgeon.

What risks are involved with eyelid surgery?

Naturally there are risks associated with any surgery, including bleeding and infection at the wound site. With eyelid surgery, there is a small risk of bleeding occurring behind the eye, which can compromise the optic nerve and lead to sight problems or even complete blindness. There is also a small risk of damage to your cornea, which will need corrective surgery. These problems, it must be stressed, are very rare.

As with other cosmetic surgery, there is always the risk that the results will not be even, and that your eyes may look different from each other. A skilled surgeon will work hard to avoid this, but a corrective operation may still be needed if you are not satisfied with the results once you have fully healed.

What does eyelid surgery cost?

Upper or lower blepharoplasty alone costs between £2,000 and £3,000, with a combined procedure costing around £5,000.

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